Clinico-epidemiological profile of colorectal cancer in Algerian patients age 40 and under: Alarming increase in incidence

Abstract

Introduction: Colorectal cancer (CRC) is rare before age 40, the average age at diagnosis is generally > 50. In our department of medical oncology in Blida (north of Algeria) we have observed an increased number of young patients with colorectal cancer. The aim of this study is to determine epidemiologic and clinical characteristics of this cancer in young patients ≤40. Methods: This is a retrospective study of patients diagnosed with CRC aged 40 and under, treated in the department of medical oncology in Blida between January 2012 and December 2016. We were interested in the clinico-epidemiological characteristics of this population. Results: During this period, 79 patients with CRC age 40 and under were seen, which is about 16.3% of all CRC patients (total: 482 patients). 44 were male (55.6%) and 35 female (44.3%), median age at diagnosis 33 years, range 16 to 40. Body mass index (BMI) was higher 25 in 22 patints (27.8%), diet higt in meat and fat was observed in 31 patients (39.2%), presence of polyps at colonoscopy was noted in 9 cases, family history of CRC was seen in 11 patients and family history of other cancer was seen in 8 patients. The most commun symptoms were pain and rectal bleeding, diagnosis delay was > 3 months in 65% of cases, the rectosigmoid was the most frequent seat, histological type was adenocarcinoma in 91.1% and mucous colloid carcinoma in 8.8%, locally advanced (III) and metastatic stages (IV) were respectively 40.5% and 36.7% of cases; the stade II was observed in 18 patients (22.7%). Conclusion: There was an alarming increase in CRC in young people (in our series). The main risk factors in young people are diet rich in meat and fat, low in vegetables and fruits, physical inactivity, excess weight, and unknown behavioral factors. Eating habits and how to live our young population must be analysed carefully. Oncogenetic consultations are necessary for people with a family history of cancer.